Browsing by Author "Khanal, Umesh"
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Publication Comparison of Fat Suppression Sequences T2 Weighted Two-Point Dixon and Short-Tau Inversion Recovery in Magnetic Resonance Imaging of Lumbar Spine: An Observational Study(Nepal Medical Association, 2025) Khanal, Umesh; Sah, Ramswarth; Mahato, Sushil Kumar; Katwal, Shailendra; Gurung, GhanshyamAbstract Introduction: Magnetic Resonance Imaging is a common diagnostic tool used to evaluate various clinical conditions. Different fat suppression techniques such as Short Tau Inversion Recovery and Dixon are employed to enhance diagnostic accuracy. The choice of fat suppression sequence varies based on availability and performance. This study aimed to compare Contrast Ratio and Contrast-to-Noise Ratio of Short Tau Inversion Recovery and Dixon technique. Methods: This observational cross-section study was performed in the Department of Radiology from 8 September 2023 to 7 September 2024 after the approval by the Institutional Review Committee (Reference number: 151/080/081(6-11)E2). Using a complete census method during the study period, MRI-lumbar spines of 384 adult patients were included in the study. Signal intensity values of the lesion, adjacent normal tissue, and noise were recorded for calculation of Contrast Ratio and Contrast-to-Noise Ratio. Results: Among 384 cases, 191 (49.74%) were male and 193 (50.26%) were female with median age 46 (IQR: 35-60) years. The median value of contrast ratio and contrast-to-noise ratio were 0.31 (IQR: 0.14-0.50) and 8.74 (IQR: 3.82-15.50) respectively for STIR sequence while median value of contrast ratio and contrast-to-noise ratio were 0.44 (IQR: 0.19-0.74) and 11.95 (IQR: 5.38-23.18) respectively for Dixon sequence, higher than Short Tau Inversion Recovery. Conclusions: Contrast Ratio and Contrast to Noise Ratio were found higher and background noise lower for Dixon compared to Short Tau Inversion Recovery.Publication Prevalence of Microalbuminuria in Non-diabetic Hypertensive Patients and its Correlation with Changes in Left Ventricular and Left Atrial Characteristics(Nepal Health Research Council, 2022) Bhusal, Khema Raj; Devkota, Surya; Pathak, Surya; Khanal, Pratik; Khanal, Umesh; Thapalia, Poojan; Neupane, Srijana; Gyanwali, Pradip; Simkhada, Rabindra; Oli, Krishna KumarAbstract Background: Microalbuminuria is urinary albumin excretion in the range of 30-300 mg per 24 hours and is considered as an abnormal albumin excretion rate. Microalbuminuria is associated with epithelial dysfunction and have a high risk for target organ damage resulting in stroke, retinopathy and adverse cardiovascular events. The objective of the study was to determine the prevalence of microalbuminuria in non-diabetic hypertensive patients and its correlation with cardiovascular changes. Methods: A quantitative cross-sectional study was done in 107 participants diagnosed as non-diabetic hypertensive patients visiting to Manmohan Memorial medical college and Teaching hospital and Manmohan Cardio-thoracic Vascular and transplant Centre. The assessed parameters were basic metabolic profile, urine evaluation and Echocardiography. Results:The results showed microalbuminuria in 28 study participants and not seen in 79 participants. Similarly, microalbuminuria was observed more comparable in those with presence of left ventricular hypertrophy as compared to the absence of left ventricular hypertrophy (29.3% versus 22.8%) (p value 0.469); those with presence of left ventricular diastolic dysfunction as compared to the absence of left ventricular diastolic dysfunction (31.1% versus 19%) (p value 0.170) and those with dilated left atrium as compared to normal left atrium (26.7% versus 23.9%) (p value 0.820). In case of left ventricular ejection fraction, those with normal left ventricular ejection fraction (26.3%) had slightly higher proportion of micro-albuminuria than those with mild to moderate left ventricular systolic dysfunction (20%) (p value= 0.755) Conclusions: There was no significant difference in the level of micro-albuminuria between non-diabetics, hypertensive patients with cardio vascular changes compared to patients with no cardiovascular changes. Keywords: Hypertension; microalbuminuria; non-diabeticPublication Ultrasound Assessment of Gestational Age Using Fetal Binocular Distance in Uncomplicated Pregnancies, Correlating with Standard Fetal Biometry Parameters at a Tertiary Care Hospital in Nepal(Perinatal Society of Nepal (PESON), 2023) Khanal, Umesh; Katwal, Shailendra; Suhail, Afla; Lohani, BenuABSTRACT Background: Fetal biometry, typically using parameters like biparietal diameter (BPD), Head circumference (HC), abdominal circumference (AC), and Femur length (FL), estimate gestational age. Recent literature highlights the utility of orbital dimensions, particularly fetal binocular distance (FBD) for precise fetal gestational age estimation (FGAE). Due to a lack of published data on FBD in Nepal, this study aimed to fill this gap by assessing GA using FBD from 18th week in healthy women with uncomplicated pregnancies. Methods: Obstetric USG was performed in 288 women with uncomplicated pregnancy to evaluate the efficacy of FBD as a measure to calculate the predicted GA. GA ranged from 18 weeks to term. Only patients with known clinical GA, previous history of normal menstrual cycle, and who fit the inclusion criteria were included in the study. Results: The correlation between FBD in mm and gestational age (GA)in weeks was analyzed. The correlation was highly significant (r=0.987, p<0.001), assisting in compiling a nomogram of FBD and GA for Nepalese women. A highly significant correlation was also found between the FBD and other parameters as well. Conclusion: Fetal binocular distance correlates linearly with clinical gestational age and positively with other standard fetal biometry parameters such as biparietal diameter, head circumference, abdominal circumference, and femur length. Thus, fetal binocular distance proves to be a reliable parameter for determining gestational age. Keywords: Gestational age, Fetal Binocular distance (FBD), Ultrasonography (USG)